Chapter 16 Intervention Integrating Gains. Social Work Endings Types of endings –Completing contracts –Client discontinues –Closing with referral Dynamics.

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Chapter 16 Intervention Integrating Gains

Social Work Endings Types of endings –Completing contracts –Client discontinues –Closing with referral Dynamics vary with size of client system Requires individually tailored processes to end in ways that benefit clients © 2013 Pearson Education, Inc. All rights reserved.

Preparing for Resolution Anticipate the end even from the beginning Remind clients of the transitory nature of the practice relationship Provide convenient exit points © 2013 Pearson Education, Inc. All rights reserved.

Discussing Readiness Reviewing progress Signal - reaching goals Evaluate what worked and what didn’t Discuss transferable strategies © 2013 Pearson Education, Inc. All rights reserved.

Evaluating Evaluate what worked Clarify effective strategies Review information useful for future challenges Bring a sense of completion to the work © 2013 Pearson Education, Inc. All rights reserved.

Feelings about Endings Sharing Feelings –Feelings about closure; Endings can be positive events; Celebrate successes Factors that influence feelings –Personal experiences with transitions –Sense of competence as professionals –Feelings toward clients © 2013 Pearson Education, Inc. All rights reserved.

Generalizing Outcomes Stabilize successes achieved Ensure access to –Social supports –Environmental resources Contract for closure © 2013 Pearson Education, Inc. All rights reserved.

Completing Contracts Firming Up Social Supports Celebrations and Ritualized Endings Looking to the Future Following Up © 2013 Pearson Education, Inc. All rights reserved.

Closing With Referral Reasons –Limited resources in current setting –Workers take new positions –Legal mandates Strategy: Recognize interim success © 2013 Pearson Education, Inc. All rights reserved.

Making Referrals Ensure clients remain in control even in transition processes Refer clients to specific persons rather than programs Collaborate with clients on how to transfer information Arrange for follow-up to track progress © 2013 Pearson Education, Inc. All rights reserved.

Clients' Discontinuation of Services Recognize clients’ privilege to discontinue Treat each session as if it could be the last Be alert for messages of pending departure Resolve unplanned exists © 2013 Pearson Education, Inc. All rights reserved.

When Clients Die Feeling loss of clients is genuine Dimensions of grief: denial, anger, bargaining, depression, and acceptance Influences on experience of grief –Age; Gender; Cultural background –Religious beliefs; Experiences with death; Access to social support © 2013 Pearson Education, Inc. All rights reserved.

End-of-Life Care Support for “dying well” Advance care planning –Planning for end-of-life care –Patient Self-Determination Act –Advance directives Living wills Durable powers of attorney for healthcare © 2013 Pearson Education, Inc. All rights reserved.

Grieving the Death of a Client Resources for resolving grief –Self-awareness –Collegial and personal support Clients’ death by accident or intention –Potential for feeling guilt © 2013 Pearson Education, Inc. All rights reserved.

Small Group Endings Closed-ended groups –Members resolve relationships with the worker, with each other, & with the group itself Open-ended groups –Workers deal with collection of members at various stages in their work in the group © 2013 Pearson Education, Inc. All rights reserved.

Resolving Intermember Relationships Structured endings –Workers plan final meetings with larger client systems Provide members with opportunities to share their thoughts and feelings about the work completed Consider the future © 2013 Pearson Education, Inc. All rights reserved.

Endings with Organizations and Communities Stabilize the functioning of the organization or community itself Consider implications of ending for relationships within the group Maintain the stability by targeting changes in policies and practices © 2013 Pearson Education, Inc. All rights reserved.

Endings are Beginnings Effective endings are beginnings –Stabilize the progress –Integrate the skills learned Benefits for workers and clients –Clients: empowerment to continue to function competently –Workers: practice wisdom for future work © 2013 Pearson Education, Inc. All rights reserved.